Dr Fran Vertue
Everyone in Christchurch has experienced extremely traumatic events over the past few days. However, our experiences have ranged from fairly mild to extremely severe, and our reactions to these experiences depend, to some extent, on our past experiences and our personalities. What we will all have to do as time goes by, is find a way to make sense of these traumatic events so that we can go on living productive lives that are not limited by the psychological results of trauma.
The human brain has very specific ways of dealing with unpredictable experiences of this kind. Any time that we are present during an event that threatens our own or other people’s lives, our brains go through two critical processes – immediately evaluating the risk, and instantaneously finding ways to avoid being destroyed. However, once the imminent danger is past, we have to find ways to integrate the memories of the terrifying events into our understanding of how the world works. The vast majority of us will not have been in a life-threatening situation before, and so our memory networks inform us that the world is generally safe and that we, or the people around us, will not suddenly die. Because they have taken our own lifetimes to reach their current state, these memory networks are slow to change.
So, for a period of time, the memories of our traumatic events “float” around – flickering in and out of our conscious awareness – before they can be built into a restructured memory system. It takes a while for us to reconcile a life-threatening event, like an earthquake, with our existing beliefs about the world being generally safe. This change process can take weeks or even months, and in the meantime, we struggle with the experiences that are commonly associated with Post-Traumatic Stress Disorder (PTSD). However, a diagnosis of PTSD requires that a month has passed since the traumatic event.
In our case, it is only five days since the 4 September, so we talk of Acute Stress Disorder – where the disturbances in our thinking, feelings and behavior have lasted for a minimum of 48 hours. Common experiences of Acute Stress Disorder are a sense of numbness, “being in a daze”, disrupted sleep, being very easily startled, feeling irritable, struggling to settle down to work, feeling disconnected from the real world (I’ve heard many people use the word ‘surreal’ to describe their experience), and having recurrent distressing images and thoughts of the event.
These experiences are likely to continue until each of us, in our own unique way, makes sense of the events and “knits” the new memories into the fabric of our existing memory networks. Over a period of time, we will isolate our individual memory fragments about the earthquake, and work out just how much each fragment changes our general perception of the world as a safe place. For example, you might remember being at home, in your bed, when the earthquake struck. You need to build this memory fragment into your existing knowledge about how safe you are in your bed. Over time, you will build this memory fragment into your general understanding of your safety in bed, and, as you build up many more safe nights in bed, your anxiety about going to bed will fade. Additionally, you will integrate your memories of coping with the danger, and your resilience will be strengthened because you know that you have survived this terrible event.
Given the differences between adults and children in terms of an appreciation of death and a capacity to see “the big picture”, there may be significant differences in the ways that adults and children cope with the earthquake and its associated events. For example, children may seem to recover faster from the trauma, and may be distracted more easily than adults from thoughts of the event. The fact is that they may be relatively unaware of the life-threatening danger involved in extremely unusual events such as an earthquake. Critically, children look to the adults around them for indications of their own safety. When adults express fear or distress, children get the message that they, too, are in danger. Importantly, children receive the vast majority of their information through non-verbal channels – it’s not always what you say to your children that impresses them, but the tone and volume of your voice, your posture, and your facial expression. Just like adults, children rely on predictability to feel safe.
So, parents can support their children’s adjustment to a traumatic event by ensuring that routines are adhered to as far as possible, that they stay close to their children, and are available to answer questions. Remember that children do best when their questions are answered briefly. Children can only process relatively small pieces of information at a time, so they can become overwhelmed if they are given comprehensive answers to simple questions. For example, the question, “Will there be another earthquake, dad?” does not require any kind of seismological answer. A simple response, such as, “I don’t know, but we did good with this one, so we’ll do good if there’s another one” would do nicely. Children primarily want to know that they are safe, and this is best accomplished by simple parental reassurances that the adults are taking care of business, and that they (the children) can concentrate on more age-appropriate pursuits.
Remember, too, that children vary enormously in their tolerance for threat. Some children are hardy creatures, who bounce back from danger almost effortlessly. Others have a much lower tolerance, becoming anxious quickly and remaining so for longer. It is vital that parents understand their child’s particular temperament in order to know how best to facilitate their adjustment to this changed world. If a child experiences high levels of anxiety over a period of time (for example, refusing to be separated from a parent), it may be helpful to seek the assistance of a specialist in children’s anxiety.
Above all, remember that this is a time to be ensuring physical and emotional safety: First, make sure you have safe food, water, shelter and clothing and that any injuries are attended to. Then make contact with the people you know and love, and take comfort from them. Then gather information about where to get assistance from relief services such as housing, work and income, food banks, or counselling. Keep your plans very simple and remember that our most fundamental needs are for our physical safety and our connections with supportive others. Anything else can wait until the danger is passed and we are recovering from the shock. Because, be in no doubt, our inner worlds will be changed forever by this earth-shattering experience.
